Medical evaluation of eye pain begins with a thorough history and physical examination. The history consists of questions documenting the symptoms in detail.
- Important questions asked include when the pain started, the location of pain, the duration of pain, the characteristics of pain, anything that makes the pain better or worse, what you were doing when the symptoms began, history of contact lens use, and previous eye injuries or surgeries.
- Other important questions are whether you have allergies to medications, your current medications, past medical history, past surgeries, family history, and social history (including your work and travel habits as well as any history of alcohol, tobacco, or illegal drug use).
- The physical examination pertaining to the eyes may consist of checking your vision, visual inspection of the eye and its surrounding tissue, and examining eye movements, visual fields (peripheral vision), and the pupil's reaction to light.
- The ophthalmologist may use instruments to get a better look at the eye.
- An ophthalmoscope, which is a special tool for visualizing the eye, is used to examine the back of the eye and to view the optic disc and blood vessels.
- A slit lamp is a microscope to view the surface of the eye up close and in detail to evaluate for possible corneal abrasions and ulcerations. It is also used to look into the anterior chamber, which is the area between the surface of the eye and the pupil.
- Eye pressure can be checked using a tonometer on the slit lamp or a device known as a Tono-Pen. These two instruments are used if glaucoma is suspected.
- The ophthalmologist may also put an anesthetic drop into your eye for both diagnostic and therapeutic purposes. This test helps to determine if the eye pain comes from the surface of the eye or from deeper structures in the eye. In most cases, pain can be relieved by the topical anesthetic if it originates from the surface of the eye.
- A dye called fluorescein may be put into the eye to detect abrasions, ulcerations, or any corneal defect. A special black light will be used in conjunction with the fluorescein to check for these problems.